Rheumatoid Arthritis & the Coronavirus

May 12, 2020

Rheumatoid arthritis (RA) affects over 1.3 million Americans and as much as 1% of the worldwide population. The disease affects the joints and causes the progressive destruction of cartilage and bone. The wrists and joints of the hands and feet, sometimes knees or elbows are stiff, painful and red with a sensation of heat, especially at night and in the morning when waking up.

Can I stop social distancing? Are immunosuppressive treatments a risk factor for COVID-19 infection? How can I fight joint stiffness in lockdown? We answer your questions!

I have rheumatoid arthritis, am I more at risk of being infected with COVID-19?

According to Dr. Patrick le Goux, rheumatologist at theAmbroise-Paré Hospital in Boulogne-Billancourt outside Paris, there is no evidence to suggest that a higher frequency of Covid-19 infection occurs in patients treated for rheumatoid arthritis, including those on immunosuppressants. However, care should be taken to respect the barrier measures.

How can I reduce joint stiffness upon waking which is exacerbated during the lockdown?

Exercise has a real anti-inflammatory role, and is indicated in patients who already have RA that has been well stabilized by treatment. There are some very simple morning exercises that take only about ten minutes to do. Dr. Patrick le Goux, who is also a specialist in sports medicine, has set up a specific program in association with the rheumatology department of the Ambroise-Paré hospital: joint mobilization exercises to do on the ground and exercises to do with a mini dumbbell weighing no more than 2.5 pounds to make the joints more supple. This program combining cardio-training, muscle strengthening, endurance-resistance, stretching postures and kinesthetic exercises is available on the YouTube in French, Polyarthrite R-ACTION.

Be careful with any coaching videos and other relaxation exercises available on the Internet that are not adapted for RA patients. Patients with rheumatic problems should be treated by specialists (doctors, physiotherapists, etc.) and avoid training videos by fitness coaches intended for the general public.

I have rheumatoid arthritis, do I need to shelter in place?

As the discussion on the end of the COVID-19 lockdown continues, RA patients may wonder if they should continue to shelter in place as the US starts to reopen businesses and public places. According to Dr. le Goux, the French Society of Rheumatology does not advise that RA patients remain isolated beyond the official period, especially for those whose RA is stable and being treated. On the other hand, people over the age of 70 and/or those who have other comorbidities (especially cardiovascular risks) should avoid resuming regular activities outside the home.

Should I stop taking my immunosuppressive medications?

Absolutely not, says Dr. le Goux. If your RA is stable with immunosuppressants and biologic treatments, then the inflammation is controlled and you are not at a higher risk of infection. So make sure you do not stop your immunosuppressive treatment or any other regimen! Continue to take your medications in the usual way, and consult your doctor regularly by telephone or by teleconsultation if possible.

I get my infusion treatment in hospital or clinic, I'm afraid of being exposed to COVID-19, are there any other options?

The hospital's dedicated COVID-19 services are highly secure. Patients can therefore safely come and continue their treatment. However, there are alternatives for some medications, including tocilizumab (ACTEMRA) which, according to some ongoing studies, could be effective in severe cases of COVID-19. This may be injected subcutaneously in hospital. This may therefore be an alternative solution for patients who are very susceptible to inflammation. This is also the case for abatacept (ORENCIA). For more information, make sure to consult your doctor.

How to find support on Carenity?

Carenity currently has thousands of patients and relatives of patients affected by rheumatoid arthritis and other inflammatory diseases. On the platform, you can find support from other members of the community. It is important that we help one another especially in this difficult context of the COVID-19 pandemic. Feel free to join in on the discussions below!

With a background in communication specialised in digital, Léa has been working at Carenity since 2013 with the objective of helping as many patients and their families as possible to find support and no longer feel...
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